“Tracheostomy” (also known as tracheotomy in some areas) can mean two things
Breathing tubes in the mouth can only be used for a short while. Tracheostomies allow patients to be connected to a breathing machine for longer periods of time. For some patients this can mean a few extra days or weeks and for others it can mean needing life support for months or for the rest of their life.
A tracheostomy decision can represent a fork in the road. For many people, tracheostomy decisions require weighing two sets of values. Being kept alive for as long as possible even it means being attached to machines OR potentially a shorter life with a focus on quality and comfort.